There are many definitions of "chronic condition", some more expansive than others. We characterize it as any condition that requires ongoing adjustments by the affected person and interactions with the health care system.

Recent data show that more than 145 million people, or almost half of all Americans, live with a chronic condition. 1That number is projected to increase by more than one percent per year by 2030, resulting in an estimated chronically ill population of 171 million.

Almost half of all people with chronic illness have multiple conditions. As a result, many managed care and integrated delivery systems have taken a great interest in correcting the many deficiencies in current management of diseases such as diabetes, heart disease, depression, asthma and others. 2, 3, 4

Those deficiencies include:

Rushed practitioners not following established practice guidelines

Lack of care coordination

Lack of active follow-up to ensure the best outcomes

Patients inadequately trained to manage their illnesses

Overcoming these deficiencies will require nothing less than a transformation of health care, from a system that is essentially reactive - responding mainly when a person is sick - to one that is proactive and focused on keeping a person as healthy as possible. 5, 6, 7 To speed the transition, in 1998 Improving Chronic Illness Care created the Chronic Care Model, which summarizes the basic elements for improving care in health systems at the community, organization, practice and patient levels. Evidence on the effectiveness of the Chronic Care Model was summarized in 2009. 16